Healthcare Provider Details

I. General information

NPI: 1346621604
Provider Name (Legal Business Name): SETH JASON SKLARE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 NW MYHRE RD FL 2
SILVERDALE WA
98383-7662
US

IV. Provider business mailing address

1950 NW MYHRE RD FL 2
SILVERDALE WA
98383-7662
US

V. Phone/Fax

Practice location:
  • Phone: 564-240-4000
  • Fax: 564-240-4119
Mailing address:
  • Phone: 564-240-4000
  • Fax: 564-240-4119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD70084175
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number55277
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35C.001109
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD70084175
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberCDR.0001550
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036159601
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: